MEDICARE: BEHAVIORAL SOLUTIONS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist
2	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1174633119
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEHAVIORAL SOLUTIONS, INC.

Provider Business Mailing Address
First Line	:	PO BOX 11947
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53211-0947
Country	:	US
Telephone Number	:	414-259-3900
Fax Number	:	414-963-0000

Provider Business Practice Location Address
First Line	:	2015 E NEWPORT AVE
Second Line	:	SUITE 409
City	:	MILWAUKEE
State	:	WI
Zip	:	53211-2984
Country	:	US
Telephone Number	:	414-259-3900
Fax Number	:	414-963-0000

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MARK GERHARD EBERHAGE
Credential	:	PHD
Telephone Number	:	414-259-3900

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	09/11/2025

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